Evidence map›Paper›PMID 36944929›Full record

Observational studyBMC neurology2023

Underlying causes of cryptogenic stroke and TIA in the nordic atrial fibrillation and stroke (NOR-FIB) study - the importance of comprehensive clinical evaluation.

B Ratajczak-Tretel, A Tancin Lambert, R Al-Ani, K Arntzen, G K Bakkejord, H M O Bekkeseth, V Bjerkeli, G Eldøen, A K Gulsvik, B Halvorsen and 21 more

Registry-linked trialOpen access · goldFull text readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02937077 (The Nordic Atrial Fibrillation and Stroke Study), which is not on this map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
2.6field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02937077 completednot on this map

The Nordic Atrial Fibrillation and Stroke Study

TypeobservationalSponsorOslo University HospitalRan2016 to 2021Enrolled259ConditionsAtrial Fibrillation, Ischemic Stroke, TIAArmsMedtronic Reveal LINQ
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Observational
  5. Observational
  6. Article
  7. Article
  8. Research square · 2023
    Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 17 institutions in 3 countries.

B Ratajczak-TretelDepartment of Neurology, Østfold Hospital Trust, Postboks 300, Grålum, 1714, Norway. barbara.ratajczak@so-hf.no.
A Tancin LambertDepartment of Neurology, Østfold Hospital Trust, Postboks 300, Grålum, 1714, Norway.
R Al-AniDepartment of Cardiology, Østfold Hospital Trust, Grålum, Norway.
K ArntzenDepartment for Neurology, Nordlandssykehuset, Bodø, Norway.
G K BakkejordDepartment for Neurology, Nordlandssykehuset, Bodø, Norway.
H M O BekkesethLillehammer Hospital, Department of Neurology, Innlandet Hospital Trust, Lillehammer, Norway.
V BjerkeliResearch Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway.
G EldøenDepartment of Neurology, Molde Hospital, Molde, Norway.
A K GulsvikDepartment of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway.
B HalvorsenInstitute of Clinical Medicine, University of Oslo, Oslo, Norway.
G A HøieDepartment of Cardiology, Østfold Hospital Trust, Grålum, Norway.
H Ihle-HansenStroke Unit, Oslo University Hospital, Ullevål, Oslo, Norway.
S IngebrigtsenDepartment of Neurology, University Hospital of North Norway, Tromsø, Norway.
C KremerDepartment of Neurology, Skåne University Hospital, Malmö, Sweden.
S B KrogsethDepartment of Neurology, Vestfold Hospital, Tønsberg, Norway.
C KruuseDepartment of Neurology, Herlev Gentofte Hospital, Herlev, Denmark.
M KurzDepartment of Neurology, Stavanger University Hospital, Stavanger, Norway.
I NakstadDrammen Hospital, Department of Neurology, Vestre Viken Hospital Trust, Drammen, Norway.
V NovotnyDepartment of Neurology, Haukeland University Hospital, Bergen, Norway.
H NaessDepartment of Neurology, Haukeland University Hospital, Bergen, Norway.
R QaziDepartment of Internal Medicine, Diakonhjemmet Hospital, Oslo, Norway.
M K RezajDepartment of Neurology, Stavanger University Hospital, Stavanger, Norway.
D M RørholtDepartment of Neurology, Molde Hospital, Molde, Norway.
L H SteffensenDepartment of Neurology, University Hospital of North Norway, Tromsø, Norway.
J SømarkLillehammer Hospital, Department of Neurology, Innlandet Hospital Trust, Lillehammer, Norway.
H TobroDepartment of Neurology, Telemark Hospital, Skien, Norway.
T C TruelsenDepartment of Neurology, Rigshospitalet University Hospital, Copenhagen, Denmark.
L WassvikDepartment of Neurology, Bispebjerg University Hospital, Copenhagen, Denmark.
K L ÆgidiusDepartment of Neurology, Bispebjerg University Hospital, Copenhagen, Denmark.
D AtarInstitute of Clinical Medicine, University of Oslo, Oslo, Norway.
A H AamodtDepartment of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Oslo University Hospital · NOØstfold Hospital Trust · NOBispebjerg Hospital · DKDiakonhjemmet Hospital · NOHaukeland University Hospital · NOInnlandet Hospital Trust · NOMolde Hospital · NONordland Hospital Trust · NOStavanger University Hospital · NOUniversity Hospital of North Norway · NOUniversity of Oslo · NOVestre Viken Hospital Trust · NOGentofte Hospital · DKLund University · SERigshospitalet · DKSykehuset i Vestfold · NOTelemark Hospital · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCryptogenic stroke is a heterogeneous condition, with a wide spectrum of possible underlying causes for which the optimal secondary prevention may differ substantially. Attempting a correct etiological diagnosis to reduce the stroke recurrence should be the fundamental goal of modern stroke management.

methodsProspective observational international multicenter study of cryptogenic stroke and cryptogenic transient ischemic attack (TIA) patients clinically monitored for 12 months to assign the underlying etiology. For atrial fibrillation (AF) detection continuous cardiac rhythm monitoring with insertable cardiac monitor (Reveal LINQ, Medtronic) was performed. The 12-month follow-up data for 250 of 259 initially included NOR-FIB patients were available for analysis.

resultsAfter 12 months follow-up probable stroke causes were revealed in 43% patients, while 57% still remained cryptogenic. AF and atrial flutter was most prevalent (29%). In 14% patients other possible causes were revealed (small vessel disease, large-artery atherosclerosis, hypercoagulable states, other cardioembolism). Patients remaining cryptogenic were younger (p < 0.001), had lower CHA

conclusionCryptogenic stroke often indicates the inability to identify the cause in the acute phase and should be considered as a working diagnosis until efforts of diagnostic work up succeed in identifying a specific underlying etiology. Timeframe of 6-12-month follow-up may be considered as optimal.

trial registrationClinicalTrials.gov Identifier NCT02937077, EudraCT 2018-002298-23.

Indexed as

Atrial FibrillationIschemic Attack, TransientIschemic StrokeStrokeCausalityElectrocardiography, AmbulatoryHumansAtrial fibrillationCryptogenic strokeGuidelinesInsertable cardiac monitorSecondary preventionStroke cause

Identifiers

PMID36944929
PMCPMC10028765
OpenAlexW4328100169

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read41
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.